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The association between primary psychotic disorders emerging in later life and neurodegenerative diseases, including Alzheimer's disease AD , is controversial. We present two female non-demented cases of psychosis with onset above the age of 60 years. Cases 1 and 2 were aged was 68 and 81 years, respectively. Although detailed neuropsychological tests detected amnesia, they had preserved daily life function.
Brain magnetic resonance imaging, N-isopropyl-p-[I] iodoamphetamine I-IMP single-photon emission computed tomography, and cardiac [I]-metaiodobenzylguanidine I-MIBG scintigraphy showed no specific abnormalities in either case. We diagnosed them with very-late-onset schizophrenia-like psychosis VLOSLP because there was no evidence that their psychoses were derived from organic diseases or affective disorders. Although VLOSLP is a disease entity supposed to be a primary psychotic disorder, some are probably secondary psychosis with insidious neurodegeneration.
Keywords: prodromal Alzheimer's disease, amyloid PET, cerebrospinal fluid, very-late-onset schizophrenia-like psychosis, case report. Since the 's, many researchers have been interested in late-onset primary psychosis 1 β 4 due to several phenomenological or psychosocial characteristics that differ from those of average-onset schizophrenia spectrum disorders.
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Late-onset primary psychosis has a clear preponderance in women living alone 5 , and patients often present with persecutory delusions and few negative symptoms 6. Therefore, late-onset primary psychosis may have a different etiology from that of average-onset schizophrenia spectrum disorders.
